scholarly journals P12.07 Long term follow-up of cavernous sinus meningiomas after stereotactic radiosurgery

2017 ◽  
Vol 19 (suppl_3) ◽  
pp. iii96-iii96
Author(s):  
R. Daniel ◽  
F. Fritsche ◽  
S. Grau ◽  
H. Treuer ◽  
M. Kocher ◽  
...  
Keyword(s):  
Stereotactic Radiosurgery ◽  
Cavernous Sinus ◽  
Long Term Follow Up

scholarly journals Cavernous sinus meningiomas

2018 ◽  
Vol 20 (2) ◽  
pp. 110-118
Author(s):  
Roberto Spiegelmann ◽  
Zvi R. Cohen ◽  
Uzi Nissim
Keyword(s):  
Stereotactic Radiosurgery ◽  
Cavernous Sinus ◽  
Linear Accelerator ◽  
Medical Center ◽  
Neurological Complications ◽  
Formidable Challenge ◽  
Long Term Follow Up ◽  
Low Incidence

Introduction: Tumors of the cranial base arising from or partially involving the cavernous sinus have represented a formidable challenge to neurosurgeons. Stereotactic radiosurgery represents an alternative to microsurgery for the management of cavernous sinus meningiomas. The present study aims to evaluate the results of radiosurgery in a large series of patients treated with a linear accelerator with a long-term follow-up. Patients and Methods: From 1993 through 2007, 462 patients with meningiomas underwent radiosurgery at the Chaim Sheba Medical Center LINAC radiosurgery unit. Of those, 117 had tumors involving predominantly the cavernous sinus. A mean follow-up of 67 months was obtained in 102 patients (range:12 to 180 months). Patients’ age ranged from 31 to 86 years (mean 57). Seventy two (70%) were females. Thirty five patients (34.3%) were initially submitted to microsurgery and 67 (65.6%) underwent stereotactic radiosurgery as the first treatment option. Patients were treated using a linear accelerator with cylindrical collimators in 44 patients (43.1%) and a minimultileaf collimator in 58 patients (56.8%). The prescription dose was delivered to the 60 to 80% isodose line (mean, 68%) in patients treated with cylindrical collimators, and to the 80% in those treated with a single conformal isocenter. Doses ranged between 12 and 17.5 Gy (mean, 13.5 Gy). Median tumor volume was 7.2 cm3 (range 0.61–23 cm3). Results: All patients were available for follow-up at 12 to 180 months after treatment (mean, 68 months; median, 60 months). The actuarial control rate was 98%. Fifty nine  patients (58%) had a volume reduction and forty one (40%) had stable tumor volumes at the end of follow-up. Two tumors grew. Overall, 4 patients had a new lasting neurological deficit (facial hypesthesia or pain in two, trochlear neuropathy in two, and visual defect in one), for an incidence of 4% in persistent neurological complications. Conclusions: This series of linear accelerator radiosurgery confirms that in the short and long term, radiosurgery affords excellent control for cavernous sinus meningiomas with a very low incidence of complications. Radiosurgery can thus be regarded as the treatment of choice for cavernous sinus meningiomas. 

Salvage Surgical Resection After Linac-based Stereotactic Radiosurgery and Radiotherapy for Newly Diagnosed Brain Metastasis

2021 ◽  
Author(s):  
Ryosuke Matsuda ◽  
Takayuki Morimoto ◽  
Tetsuro Tamamoto ◽  
Nobuyoshi Inooka ◽  
Tomoko Ochi ◽  
...  
Keyword(s):  
Brain Metastasis ◽  
Survival Time ◽  
Stereotactic Radiosurgery ◽  
Surgical Resection ◽  
Cyst Formation ◽  
Histopathological Diagnosis ◽  
Newly Diagnosed ◽  
Long Term Follow Up

Abstract Purpose: This study aimed to assess the clinical outcomes of salvage surgical resection (SSR) after stereotactic radiosurgery and fractionated stereotactic radiotherapy (SRS/fSRT) for brain metastasis.Methods: Between November 2009 and December 2018, we treated 427 consecutive patients with 919 lesions with SRS/fSRT for newly diagnosed brain metastasis at our hospital. During the follow-up period, we treated 19 consecutive patients who underwent 21 SSRs for recurrence, radiation necrosis (RN), and cyst formation after SRS/fSRT for newly diagnosed brain metastasis. Two patients underwent multiple surgical resections. Brain metastasis originated from the lung (n=15, 78.9%), breast (n=3, 15.7%), and colon (n=1, 5.2%). Results: The median time from initial SRS/fSRT to SSR was 14 months (range: 2–96 months). The median follow-up after SSR was 15 months (range: 2–76 months). The range of tumor volume at initial SRS/SRT was 0.121–21.459 cm3 (median: 2.188 cm3). Histopathological diagnosis after SSR was recurrence, RN and cyst formation in 13 and 6 cases, respectively. The median survival time from SSR and from initial SRS/SRT was 17 months and 74 months, respectively. The cases with recurrence had a significantly shorter survival time than those without recurrence (p=0.0453).Conclusion: The patients treated with SRS/fSRT for brain metastasis need long-term follow-up. SSR is a safe and effective treatment for the recurrence, RN, and cyst formation after SRS/fSRT for brain metastasis.

Long-Term Follow-Up of 32 Meningiomas of the Clivus and Foramen Magnum Subjected to Stereotactic Radiosurgery

Radiosurgery ◽  
2010 ◽  
pp. 202-211
Author(s):  
K. Sallabanda ◽  
J.C. Bustos ◽  
J.A. Gutiérrez-Díaz ◽  
C. Beltrán ◽  
C. Peraza ◽  
...  
Keyword(s):  
Stereotactic Radiosurgery ◽  
Foramen Magnum ◽  
Long Term Follow Up

Place of Gamma Knife Stereotactic Radiosurgery in Grade 4 Vestibular Schwannoma Based on Case Series of 86 Patients with Long-Term Follow-Up

2018 ◽  
Vol 114 ◽  
pp. e1192-e1198 ◽  
Author(s):  
Michel Lefranc ◽  
Leila Maria Da Roz ◽  
Anne Balossier ◽  
Jean Marc Thomassin ◽  
Pierre Hugue Roche ◽  
...  
Keyword(s):  
Stereotactic Radiosurgery ◽  
Gamma Knife ◽  
Vestibular Schwannoma ◽  
Case Series ◽  
Long Term Follow Up ◽  
Gamma Knife Stereotactic Radiosurgery

scholarly journals GP.05 The risk of malignancy after stereotactic radiosurgery

2018 ◽  
Vol 45 (s2) ◽  
pp. S9-S9
Author(s):  
AM Wolf ◽  
K Naylor ◽  
D Kondziolka
Keyword(s):  
Stereotactic Radiosurgery ◽  
Incidence Rate ◽  
Malignant Transformation ◽  
The United States ◽  
Benign Tumors ◽  
Long Term Follow Up ◽  
Risk Of Malignancy ◽  
Associated Malignancy

Background: A major concern of patients undergoing Gamma Knife radiosurgery (GKS) for benign tumors and other conditions is the risk of a separate secondary malignancy or malignant -transformation. The incidence of radiosurgery-associated malignancy based on long-term follow-up remains unknown. Methods: We conducted a population-based cohort study to estimate the incidence rate of both malignant transformation and a separate radiation-associated malignancy in patients undergoing GKS from 1987 to 2016 at 5 centers. Results: 11 527 patients underwent radiosurgery for meningioma (n=3261), arteriovenous malformation (n=2868), trigeminal neuralgia (n=1982), vestibular schwannoma (n=1957), pituitary adenoma (n=1193), other (n=266). The follow-up time ranged from 0.3 to 23.8 years. Four cases of malignant transformation and 3 new malignant brain tumors were reported, two of which were not within the irradiated field. The incidence of malignant transformation was 6.6 per 100 000 patient-years and of new malignancy, either locally or distant, was 5 in 100 000 patient-years. These risks are not higher than the Central Brain Tumor Registry of the United States derived annual incidence rate of all primary malignant CNS tumors of 7.15 per 100 000. Conclusions: Physicians can safely counsel patients that the risk of malignancy after stereotactic radiosurgery remains extremely low, even at long-term follow-up of greater than 10 years.

scholarly journals Long-term follow-up of stereotactic radiosurgery for head and neck malignancies

Head & Neck ◽  
2014 ◽  
Vol 37 (11) ◽  
pp. 1557-1562 ◽  
Author(s):  
Dawn Owen ◽  
Fawaad Iqbal ◽  
Bruce E. Pollock ◽  
Michael J. Link ◽  
Kathy Stien ◽  
...  
Keyword(s):  
Head And Neck ◽  
Stereotactic Radiosurgery ◽  
Head And Neck Malignancies ◽  
Long Term Follow Up

Long-term Follow-up of Patients with Meningiomas Involving the Cavernous Sinus: Recurrence, Progression, and Quality of Life

Neurosurgery ◽  
1996 ◽  
Vol 39 (5) ◽  
pp. 915-920 ◽  
Author(s):  
Orlando De Jesús ◽  
Laligam N. Sekhar ◽  
Hemen K. Parikh ◽  
Donald C. Wright ◽  
Douglas P. Wagner
Keyword(s):  
Quality Of Life ◽  
Cavernous Sinus ◽  
Long Term Follow Up

Long-term Follow-up of Patients with Meningiomas Involving the Cavernous Sinus: Recurrence, Progression, and Quality of Life

Neurosurgery ◽  
1996 ◽  
Vol 39 (5) ◽  
pp. 915-920 ◽  
Author(s):  
Orlando De Jesús ◽  
Laligam N. Sekhar ◽  
Hemen K. Parikh ◽  
Donald C. Wright ◽  
Douglas P. Wagner
Keyword(s):  
Quality Of Life ◽  
Cavernous Sinus ◽  
Long Term Follow Up

scholarly journals Gamma Knife stereotactic radiosurgery for cavernous sinus meningioma: long-term follow-up in 200 patients

2019 ◽  
Vol 130 (6) ◽  
pp. 1799-1808 ◽  
Author(s):  
Kyung-Jae Park ◽  
Hideyuki Kano ◽  
Aditya Iyer ◽  
Xiaomin Liu ◽  
Daniel A. Tonetti ◽  
...  
Keyword(s):  
Tumor Progression ◽  
Stereotactic Radiosurgery ◽  
Gamma Knife ◽  
Cavernous Sinus ◽  
Gamma Knife Radiosurgery ◽  
Tumor Control ◽  
Cavernous Sinus Meningioma ◽  
Long Term Study

OBJECTIVEThe authors of this study evaluate the long-term outcomes of stereotactic radiosurgery (SRS) for cavernous sinus meningioma (CSM).METHODSThe authors retrospectively assessed treatment outcomes 5–18 years after SRS in 200 patients with CSM. The median patient age was 57 years (range 22–83 years). In total, 120 (60%) patients underwent Gamma Knife SRS as primary management, 46 (23%) for residual tumors, and 34 (17%) for recurrent tumors after one or more surgical procedures. The median tumor target volume was 7.5 cm3 (range 0.1–37.3 cm3), and the median margin dose was 13.0 Gy (range 10–20 Gy).RESULTSTumor volume regressed in 121 (61%) patients, was unchanged in 49 (25%), and increased over time in 30 (15%) during a median imaging follow-up of 101 months. Actuarial tumor control rates at the 5-, 10-, and 15-year follow-ups were 92%, 84%, and 75%, respectively. Of the 120 patients who had undergone SRS as a primary treatment (primary SRS), tumor progression was observed in 14 (11.7%) patients at a median of 48.9 months (range 4.8–120.0 months) after SRS, and actuarial tumor control rates were 98%, 93%, 85%, and 85% at the 1-, 5-, 10-, and 15-year follow-ups post-SRS. A history of tumor progression after microsurgery was an independent predictor of an unfavorable response to radiosurgery (p = 0.009, HR = 4.161, 95% CI 1.438–12.045). Forty-four (26%) of 170 patients who had presented with at least one cranial nerve (CN) deficit improved after SRS. Development of new CN deficits after initial microsurgical resection was an unfavorable factor for improvement after SRS (p = 0.014, HR = 0.169, 95% CI 0.041–0.702). Fifteen (7.5%) patients experienced permanent CN deficits without evidence of tumor progression at a median onset of 9 months (range 2.3–85 months) after SRS. Patients with larger tumor volumes (≥ 10 cm3) were more likely to develop permanent CN complications (p = 0.046, HR = 3.629, 95% CI 1.026–12.838). Three patients (1.5%) developed delayed pituitary dysfunction after SRS.CONCLUSIONSThis long-term study showed that Gamma Knife radiosurgery provided long-term tumor control for most patients with CSM. Patients who underwent SRS for progressive tumors after prior microsurgery had a greater chance of tumor growth than the patients without prior surgery or those with residual tumor treated after microsurgery.

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